Organization
ORTHOTECHS O & P
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMM WILSON (PRESIDENT)
(308) 865-6060
Entity
Organization
Contact information
Practice address
3811 CENTRAL AVE, SUITE F, KEARNEY, NE 68847-8173
(308) 865-6105
Mailing address
3811 CENTRAL AVE, SUITE F, KEARNEY, NE 68847-8173
(308) 865-6105
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025161300
—
NE
Enumeration date
01/21/2006
Last updated
06/09/2010
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